MedicaidPrior AuthMedium impact
iDose® TR (travoprost) intracameral implant (Revised)
Humana·KY, SC, VA · Ophthalmology·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 25, 2026
Summary
Humana has revised its prior authorization policy for iDose® TR (travoprost) intracameral implant for Medicaid members in Kentucky, South Carolina, and Virginia, effective June 1, 2026. The policy requires prior authorization for this glaucoma/ocular hypertension treatment and establishes specific approval criteria, exclusions (corneal endothelial cell dystrophy and prior corneal transplantation), and contraindications that billing teams must verify before claim submission.
Action Required
By June 1, 2026: Billing team must implement prior authorization requirements for iDose TR (travoprost) intracameral implant claims for Medicaid members in Kentucky, South Carolina, and Virginia. Before submitting claims: (1) Verify member has documented diagnosis of open angle glaucoma or ocular hypertension; (2) Confirm member does NOT have corneal endothelial cell dystrophy (e.g., Fuchs' dystrophy) or history of prior corneal transplantation (e.g., DSAEK); (3) Obtain prior authorization from Humana before processing claims. Update billing system and provider encounter forms to flag iDose TR as requiring prior auth for these three state Medicaid programs. Route all requests through www.humana.com/PAL for preauthorization and notification list coding. Claims submitted without required prior authorization will be denied.